Fouad Zouaidia

Renal myelolipoma: a rare extra-adrenal tumor in a rare site: a case report and review of the literature

IntroductionMyelolipomas are uncommon, benign tumors composed of mature adipose tissue and hematopoietic elements. They mostly occur in the adrenal glands, but extra-adrenal myelolipomas have also been reported in other locations such as the presacral region, retroperitoneum, pelvis and mediastinum. Here, we present a case of an extra-adrenal myelolipoma in a rare site: the renal parenchyma. To the best of our knowledge, it is only the third case reported in this unusual location.Case presentationWe report a case of primary myelolipoma occurring in the kidney of a 55-year-old Moroccan man. We describe the radiological and clinicopathologic features of this unusual tumor with a review of the literature, and we discuss differential diagnosis of retroperitoneal myelolipomas.ConclusionThis case is noteworthy because the tumor site was unusual. Although renal myelolipoma is rare, it should be considered in the differential diagnosis of lesions in this site.

A gallbladder tumor revealing metastatic clear cell renal carcinoma: report of case and review of literature

Metastatic renal cell carcinoma in the gallbladder is extremely rare, with reported frequencies of less than 0.6% in large autopsy reviews. Only 40 cases were reported in the literature. We report a first case of gallbladder polypoid tumor revealing metastatic clear cell renal cell carcinoma, which demonstrates the importance of radiological tests, histology and immunohistochemistry when making a definitive diagnosis. These examinations also allow differentiating metastatic clear cell renal cell carcinoma from other polypoid lesions in the gallbladder with clear cell morphology. Cholecystectomy should be performed to obtain a definitive diagnosis and to improve survival in case of solitary metastatic renal cell carcinoma.Virtual slidesThe virtual slides’ for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/8956897238238989

Primary retroperitoneal mucinous cystadenoma with borderline malignancy in a male patient: a case report

IntroductionPrimary retroperitoneal mucinous cystadenoma is a rare tumor prevailing specifically in female gender. Its histogenesis is still unclear and its diagnosis is mainly based on morphological characteristics.Case presentationthe subject is a 44 years old man presenting an abdominal pain on the right side, with a palpable mass which appeared four months ago. Abdominal ultrasound (echography) revealed a retroperitoneal cystic process, which was successfully resected through laparotomy.Histopathological examination concluded to a mucinous cystadenoma with borderline malignancy foci.After a year of follow-up, no relapse was noticed in this patient.ConclusionRetroperitoneal mucinous cystadenoma is a rare tumor that should be considered in front of a retroperitoneal cystic process. Several hypotheses may explain the histogenesis of this pathological process.The interest in publishing this case report on primary retroperitoneal mucinous cystadenoma in a male patient lies in the rarity of occurrence of this syndrom in males as compared to females.

Spontaneous rupture of a recurrent hepatic cystadenoma

Biliary cystadenoma is a rare cystic tumor of the middle aged woman that usually arises in the liver or occasionally in the extrahepatic bile ducts. It has a strong potential for recurrence and for malignant transformation. The lack of specific clinical and biological features hinders diagnosis before surgery. The spontaneous rupture of a hepatobiliary cystadnoma is a very rare and potentially life-threatening complication, with only two reported cases in the English literature. We report a case with spontaneous rupture of a recurrent hepatobiliary cystadenoma in a 32 year-old woman.

Combined myoepithelial carcinoma and myoepithelioma in soft tissue: a case report and review of the literature

IntroductionSoft tissue myoepithelial carcinoma and myoepithelioma are rare entities, part of myoepithelial tumors. They were incorporated into the World Health Organization classification of soft tissue tumors in 2002. Here we present an exceptional case of myoepithelial carcinoma and myoepithelioma association. To the best of our knowledge, such an association has never been reported in the literature.Case presentationWe report a case of myoepithelial carcinoma combined with myoepithelioma occurring in the soft tissue of the right forearm of an 84-year-old Arabian man. We describe the clinical, radiological and pathological features dominated by histological polymorphism. We will also describe the proposed histological criteria of malignancy and the major role of immunohistochemistry in positive and differential diagnosis. We finally mention the therapeutic arsenal available.ConclusionThrough this work, we report that myoepithelioma of soft tissue can progress to malignant myoepithelioma.

Pulmonary epithelioid hemangioendothelioma: a case report

IntroductionThe pulmonary epithelioid hemangioendothelioma is a rare vascular intermediate malignancy tumour.Case presentationA 45-year-old man, he shows an isolated chronic cough with a preserved general state of health. The thoracoabdominal Computed tomography showed three well limited opacities of the right lung, among them one shows some calcifications; which we entirely resected by enucleation after a pneumotomy. The histologic examination with immunomarking led to an epithelioid hemangioendothelioma.ConclusionsThe pulmonary epithelioid hemangioendothelioma is a tumour of unpredictable prognosis, bad when linked to the plurifocal and symptomatic forms.

Calcified multilocular thymic cyst associated with thymoma: a case report

IntroductionThere are few case reports of thymoma with a thymic cyst. Such an association renders it difficult for any pathologist to differentiate from other neoplasms, such as a cystic thymoma.Case presentationA 50-year-old Berber woman from Morocco was admitted with a chronic cough of more than 10 years duration. Her medical history and physical examination were normal. Anterior chest radiography demonstrated a calcified opacity in her right anterior mediastinum. A chest-computed tomogram revealed a round cystic tumor, with significant calcification in her right anterior mediastinum. A surgical exploration was performed. The tumor seemed to be a well-encapsulated and totally calcified lesion, arising from the right lobe of her thymus. It was removed by partial resection of her thymus. Through histology, the calcified tumor exhibited some areas of multilocular fibrous-wall cysts. These cysts were partially lined by small cuboidal cells with severe chronic inflammation and an AB thymoma that arose from the wall of the cyst.ConclusionGreater attention should be given to multilocular thymic cysts, to exclude the possibility of neoplasm, especially when the cyst wall is thickened.

Non-traumatic myositis ossificans circumscripta: A diagnosis trap

Myositis ossificans circumscripta (MOC) is a benign condition of non-neoplastic heterotopic bone formation in the muscle or soft tissue. Trauma plays a role in the development of MOC, thus, non-traumatic MOC is very rare. Although MOC may occur anywhere in the body, the lesions are localized predominantly in the high-risk sites of injury, such as the thigh, buttock, and elbow. MOC can easily be mistaken for osteomyelitis or a malignant tumor, specifically osteosarcoma or soft-tissue sarcoma. We report a rare case of non-traumatic myositis ossificans circumscripta of thigh which appear clinically and radiologically as a malignant neoplasm. Despite its rarity, MOC should be contemplated in the differential diagnosis of malignant tumors.

Primary endobronchial leiomyosarcoma of the lung: clinical, gross and microscopic findings of two cases.

Primary leiomyosarcoma of the lung is an unusual malignant tumor. Among this entity, the endobronchial form is very rare and the preoperative diagnosis is extremely difficult. We present two different presentations and outcomes of primary endobronchial leiomyosarcoma of the lung. In both cases, the histological study and the immunohistochemical stain, of the surgical resection, provided the final diagnosis. Through those cases we present the diagnostic and therapeutic difficulties encountered.

Small bowel volvulus with intussusception: an unusual revelation of neuroendocrine tumor

The primary malignant tumors of the small bowel are rare, representing 1 to 1.4% of all gastrointestinal tumors. We report a case of a 33 year-old women, admitted to our emergency department of visceral surgery for acute abdomen. The clinical examination revealed diffuse abdominal distension, defenseless, the hernia orifices were free and the rectal examination was normal. The biological test showed no hydro electrolytic disorders with normal hemoglobin and normal renal function. The abdominal CT-Scan showed signs of bowel obstruction due to a volvulus with intussusception without ischemia. The patient was operated urgently; the exploration has revealed a small bowel obstruction in the ileum with volvulus, an intussusceptum associated with a retractile mesenteritis, and the hepatic exploration found no metastases. The patient underwent a bowel resection taking away the intussusceptum with the infiltrated mesentery. The postoperative course was uneventful. The pathological result has proved a well-differentiated neuroendocrine tumor with five free nodes. Through this observation, we aim to highlight that an obstruction of small bowel with volvulus and intussusception could be exceptionally due to a neuroendocrine tumor, this complication has enabled a relatively early diagnosis in the absence of metastases and a 6-month follow-up without recurrence is a demonstration.